Posting in Cancer
Your risk for developing an aggressive form of these cancers may be genetic, and testing for abnormalities can give us this crucial answer sooner.
Wake Forest researchers have identified a genetic variant leading to the most aggressive form of prostate cancer.
rs4054823 confers a 25% higher risk of having the nastier form of the disease.
More study is needed to find other variants that also show increased risk. That would be followed by creation of a genetic test that would tell people not only how bad their cancer is, but what their risk of getting an aggressive cancer is before they get it.
This is important, because "you have cancer" doesn't tell you much. Some men are having their prostates removed when it's not necessary, because if the cancer hasn't spread this effects a 100% cure. (If the cancer is slow-growing, you're better off with the prostate intact.) Others are losing their lives, thinking "prostate cancer" isn't that bad a deal. (I had a neighbor in this category. I miss him.)
It's identical to the problem we have with breast cancer. Women are losing breasts who don't have to. They are told to get annual screenings at age 40, but many screenings yield false positives, or catch cancers that are not that dangerous.
We had a scare like this in our family last year. A lump was found on my daughter's breast. A biopsy showed there was no cancer, but this sort of thing happens all the time. Some friends have to go through an annual dance with their doctors, learning there is a problem, getting new tests, then learning there is no problem.
Want something that will kill you? Worrying every year whether you're about to die from cancer will kill you.
Loyola University researchers have just announced a 21-gene test that can help some women avoid chemotherapy, and there are tests for the genetic markers of breast cancer risk, but so far genetic tests in this area are not popular.
This can, and will change. What the hullaballoo over annual screenings should tell us is we need to change what we say about breast and prostate cancer.
It's not a death sentence. Some cancers are highly aggressive. Others are not. Your risk for developing an aggressive form of these cancers may be genetic, and testing for abnormalities can give us this crucial answer sooner.
Annual screenings alone won't keep you safe. They could, in fact, leave you mutilated. What we need is more genetic information, about you and your cancer.
We're getting that.
(Note: I've never understood the deal with a Demon Deacon mascot. Isn't that sort of, well, contradictory? It's as crazy as Tulsa's "Golden Hurricane." I know, they're trying not to say tornado, but it sounds like someone is going to the bathroom in a high wind. Written by someone whose friends can't help always giving him the bird.)
Jan 12, 2010
We don't often tell patients the severity of cancers before we recommend radical prostectomy. We just say "this will effect a cure." Same is true, I believe, with breast cancers. We can get a better clue as to the potential of a cancer cell as we learn the genetic markers distinguishing aggressive from less aggressive forms of the disease. And we can get a better clue as to the need for screening if we know the genetic markers that make one more susceptible to specific types of cancer. We also save money.
A slow prostate cancer may be more amienable to a targetted biopsy removal, rather than total removal of the prostate. It's not that the prostate is that valuable an organ for men past "childbearing" age that we can't do without it. It's that the nerves and urethra running through that area are so easily damaged that total removal of the prostate results in urinary incontinence; often permanently; as well as possible sexual impotence, err erectile dysfunction, that no amount of enzyte or viagra can help.